The application of total quality management principles to health care requires that customer satisfaction be monitored. Hospitals have developed such customer satisfaction tracking systems, but the issues involved in monitoring satisfaction in long-term care are different and more problematic. This proposal will develop a methodology that will permit consulting firms and nursing homes to reliably collect usable customer information from long-term care residents (nursing homes plus board and care), and their families. The methodology will be particularly developed to obtain satisfaction information from representative samples of cognitively impaired nursing home residents. Specific suggestions made by customers for changes in services will be analyzed and a long-term care management committee will be charged with the responsibility of utilizing these data to make changes in the service delivery. Measures will be taken of how useful the committee finds the customer information in making these decisions. The intent of this proposal is to describe a data collection, analysis, and presentation system that will increase the responsiveness of long-term direct care providers to their customer's needs. PROPOSED COMMERCIAL APPLICATION: A manual of consumer surveys with instructions for a standardized methodology to gather consumer data, along with a software package to implement analysis will be attractive to facilities that are industry leaders. A service to analyze and interpret consumer data and compare the data:with competing facilities, as well as recommend continuous process improvement actions would be attractive to a large proportion of LTC facilities.